Establishing a Crown Agency Amid Multiple Service Providers: Self-Directed Personal Support Services Ontario (SDPSSO)
Bibliographic record
Abstract
Directly funded (DF) home care is a policy mechanism where individuals are given funds to arrange their own services by hiring people in their communities or by subcontracting to service provider organizations.In 2017, the Ontario Ministry of Health and Long-Term Care briefly established a crown agency called Self-Directed Personal Support Services Ontario (SDPSSO).The stated goal of the SDPSSO was to create a DF home care program to serve older people, expanding an existing Ontario program serving a small number of younger adults with disabilities.The development of SDPSSO was influenced by the then health minister's ideological belief, pressure to reform home care from multiple stakeholders, and positive (although sparse) international evidence of the efficacy of DF home care among older adults.Reaction to the policy shift included a judicial injunction brought forward by a coalition group of home care service providers, halting implementation.A SWOT analysis shows that the SDPSSO provided as many threats and unknowns as there were possible benefits.A change in provincial government resulted in the dissolution of the SDPSSO in 2018 and the introduction of a family-managed program that continues to exclude older people.It is unclear what future changes may be in store for home care in Ontario. Self-Directed Personal
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.011 | 0.005 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".